Evaluación de la efectividad y satisfacción de las pacientes tras miomectomía histeroscópica en consulta / Evaluation of effectiveness and patient satisfaction of hysteroscopic myomectomy in office

OBJETIVO: Analizar la efectividad de las miomectomías histeroscópicas en consulta realizadas con minirresector y conocer si hay factores relacionados con el grado de satisfacción de las pacientes. MÉTODO: Estudio observacional, transversal y prospectivo, de mujeres sometidas a miomectomía histeroscópica en consulta durante el año 2018. Las pacientes recibieron medicación para la preparación cervical, analgesia oral y anestesia paracervical. La miomectomía se realizó con un minirresector de 5.8 mm. Se registraron el tiempo y el dolor en una escala visual analógica (EVA) durante la entrada y la resección, así como la satisfacción de las pacientes a los 3 meses con el cuestionario validado CSQ-8. RESULTADOS: El estudio incluyó 59 pacientes. El tiempo medio de entrada fue menor de 1 minuto (47,93 segundos) y el de resección fue de 13,51 minutos. El dolor referido por las pacientes en la EVA durante la entrada y la resección puntuó en torno a 3 y 4, respectivamente. Se consiguió un 74.6% de resecciones completas de los miomas y la puntuación media de satisfacción de las pacientes fue de 27.17. La resección completa del mioma se asoció con una mayor satisfacción total de las pacientes. CONCLUSIONES: La miomectomía histeroscópica en consulta llevada a cabo con un minirresector de 5.8 mm con analgesia paracervical obtiene buenos resultados clínicos, con buena satisfacción de las pacientes. Esta última se relaciona con una resección completa del mioma, sin que influyan el tiempo necesario para su exéresis ni el dolor.

OBJECTIVE: To analyze the effectiveness of hysteroscopic myomectomy in office performed with mini-resectoscope, and to know if there is any variable related with patient satisfaction. METHOD: Observational and prospective transversal study, which included all women who underwent a hysteroscopic myomectomy in office in 2018. Patients received drugs for cervical preparation and pain management, as well as paracervical block. We used the 5.8 mm mini-resectoscope. We kept record of time and AVS pain during entrance and resection, as well as patient satisfaction 3 months after the procedure using the CSQ-8. RESULTS: The study included 59 patients. Mean entrance time was less than 1 minute (47.93 seconds), while mean resection time was 13.51 minutes. AVS pain during entrance and resection was around 3 and 4, respectively. We achieved 74.6% rate of complete resection. Mean patient satisfaction rate was 27.17 points. We found that a complete myoma resection is related to higher patient satisfaction. CONCLUSIONS: Hysteroscopic myomectomy in office performed with the 5.8 mm mini-resectoscope, using cervical block, achieves good clinical results and a good patient satisfaction. Patient satisfaction is associated with a complete resection of the myoma, without any influence of pain experienced or time required.

Evaluating the Safety and Effectiveness of Super?cial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia and Local Anesthesia in Space Infections: A Prospective Clinical Study

Background: Regional anesthesia is the most commonmethod to anesthetize the patient prior to office basedprocedures. Many techniques can be employed to achieveanesthesia of the dentition and surrounding hard and softtissues of the maxilla and mandible. Aim of the study Toassess the safety and effectiveness of super fi cial cervicalplexus (SCP) block in oral and maxillofacial surgical (OMFS)practice as an alternative to general anesthesia in selectivecases.Materials and Methods: The total number of patients was 50,out of which 35 were male and 15 were female patients.Informed & written consent were obtained from the patientsafter they had the procedure explained tothem. Medicallycompromised patients and those who were excessivelyanxious and apprehensive, patient who did not want theprocedure to be done under regional anesthesia, and patientswitha history of allergy tolocal anesthetic were excluded. Allpatients had their surgical procedures under regionalanesthesia (SCP block with supplemental nerve blocks)performed by the same surgeon under the supervision ofanesthesiologist with continuous monitoring.Results: SCP block with concomitant mandibular nerve andlong buccal nerve block has a high success rate, lowcomplication rate, and high patient acceptability as shown inthe study.Conclusion: Superficial cervical plexus block anesthesia is asafe and useful anesthetic technique with the low risk ofaccidents and complications, thus a good alternative forregional anesthesia in OMFS cases.

Submental Lipoma-Clinical Report of the Case and Review of the Literature.

Lipomas is the commonest tumour of subcutaneous tissue. It may occur anywhere in the body, but are very infrequent in the head and neck. Clinically they confuse with other soft tissue masses, especially if the present in the head and neck region. Malignancy has to be ruled out if the large neck swelling with increased rapid recent growth. . Improved diagnostic imaging technology (such as CT or MRI) has been very beneficial for the knowledge of extension and surgical plan of the tumour mass.The best treatment modality so far has been surgical excision. In this present study, a 45-year-old woman who presented with a enlarged submental mass which was present since 2 months but has started growing rapidly since 15 days is described. Surgical excision under bilateral cervical block was performed. A 7cm ×4cm mass was successfully removed. The surgery produced no functional impairment and good cosmetic results. Review of literature is also included.